Objective: Evaluate the effectiveness of analgesia after modified radical mastectomy (MRM)

with ESP block levobupivacaine under ultrasound guidance and adverse efects of this method.

Methods: Twenty ASA 1&2 patients, undergoing modified radical mastectomy under general

anesthesia were studied. The ultrasound-guided erector spinae plane block was done just before

extubation with levobupivacaine 0.5% (8ml administered every 6 hours). 20mg nefopam was

used to rescue whenever VAS score ≥ 4. Postoperative VAS score (resting and moving) at

extubation time, 1, 6, 12, 18, 24, 48, 72 hour postoperation, the patient satisfaction and adverse

effects were recorded.

Results: The resting and moving VAS scores were less than 4 at the time points of survey with

adverse effect (misalignment of catheter position 5%). The rate of satisfied and completely

satisfied patient were very high (30% and 70%, respectively).

Conclusion: Erector spinae plane (ESP) block serve safe and effective pain management after

modified radical mastectomy.